By Margarita Tartakovsky, M.S.
When you’re feeling anxious, you might feel stuck and unsure of how to feel better. You might even do things that unwittingly fuel your anxiety. You might hyperfocus on the future, and get carried away by a slew of what-ifs.
What if I start to feel worse? What if they hate my presentation? What if she sees me sweating? What if I bomb the exam? What if I don’t get the house?
You might judge and bash yourself for your anxiety. You might believe your negative, worst-case scenario thoughts are indisputable facts.
Thankfully, there are many tools and techniques you can use to manage anxiety effectively. Below, experts shared healthy ways to cope with anxiety right here, right now.
1. Take a deep breath.
“The first thing to do when you get anxious is to breathe,” said Tom Corboy, MFT, the founder and executive director of the OCD Center of Los Angeles, and co-author of the upcoming book The Mindfulness Workbook for OCD.
Deep diaphragmatic breathing is a powerful anxiety-reducing technique because it activates the body’s relaxation response. It helps the body go from the fight-or-flight response of the sympathetic nervous system to the relaxed response of the parasympathetic nervous system, said Marla W. Deibler, PsyD, a clinical psychologist and director of The Center for Emotional Health of Greater Philadelphia, LLC.
She suggested this practice: “Try slowly inhaling to a count of 4, filling your belly first and then your chest, gently holding your breath to a count of 4, and slowly exhaling to a count of 4 and repeat several times.”
2. Accept that you’re anxious.
Remember that “anxiety is just a feeling, like any other feeling,” said Deibler, also author of the Psych Central blog “Therapy That Works.” By reminding yourself that anxiety is simply an emotional reaction, you can start to accept it, Corboy said.
Acceptance is critical because trying to wrangle or eliminate anxiety often worsens it. It just perpetuates the idea that your anxiety is intolerable, he said.
But accepting your anxiety doesn’t mean liking it or resigning yourself to a miserable existence.
“It just means you would benefit by accepting reality as it is – and in that moment, reality includes anxiety. The bottom line is that the feeling of anxiety is less than ideal, but it is not intolerable.”
3. Realize that your brain is playing tricks on you.
Psychiatrist Kelli Hyland, M.D., has seen first-hand how a person’s brain can make them believe they’re dying of a heart attack when they’re actually having a panic attack. She recalled an experience she had as a medical student.
“I had seen people having heart attacks and look this ill on the medical floors for medical reasons and it looked exactly the same. A wise, kind and experienced psychiatrist came over to [the patient] and gently, calmly reminded him that he is not dying, that it will pass and his brain is playing tricks on him. It calmed me too and we both just stayed with him until [the panic attack] was over.”
Today, Dr. Hyland, who has a private practice in Salt Lake City, Utah, tells her patients the same thing. “It helps remove the shame, guilt, pressure and responsibility for fixing yourself or judging yourself in the midst of needing nurturing more than ever.”
4. Question your thoughts.
“When people are anxious, their brains start coming up with all sorts of outlandish ideas, many of which are highly unrealistic and unlikely to occur,” Corboy said. And these thoughts only heighten an individual’s already anxious state.
For instance, say you’re about to give a wedding toast. Thoughts like “Oh my God, I can’t do this. It will kill me” may be running through your brain.
Remind yourself, however, that this isn’t a catastrophe, and in reality, no one has died giving a toast, Corboy said.
“Yes, you may be anxious, and you may even flub your toast. But the worst thing that will happen is that some people, many of whom will never see you again, will get a few chuckles, and that by tomorrow they will have completely forgotten about it.”
Deibler also suggested asking yourself these questions when challenging your thoughts:
“Is this worry realistic?
Is this really likely to happen?
If the worst possible outcome happens, what would be so bad about that?
Could I handle that?
What might I do?
If something bad happens, what might that mean about me?
Is this really true or does it just seem that way?
What might I do to prepare for whatever may happen?”
5. Use a calming visualization.
Hyland suggested practicing the following meditation regularly, which will make it easier to access when you’re anxious in the moment.
“Picture yourself on a river bank or outside in a favorite park, field or beach. Watch leaves pass by on the river or clouds pass by in the sky. Assign [your] emotions, thoughts [and] sensations to the clouds and leaves, and just watch them float by.”
This is very different from what people typically do. Typically, we assign emotions, thoughts and physical sensations certain qualities and judgments, such as good or bad, right or wrong, Hyland said. And this often amplifies anxiety. Remember that “it is all just information.”
6. Be an observer — without judgment.
Hyland gives her new patients a 3×5 index card with the following written on it: “Practice observing (thoughts, feelings, emotions, sensations, judgment) with compassion, or without judgment.”
“I have had patients come back after months or years and say that they still have that card on their mirror or up on their car dash, and it helps them.”
7. Use positive self-talk.
Anxiety can produce a lot of negative chatter. Tell yourself “positive coping statements,” Deibler said. For instance, you might say, “this anxiety feels bad, but I can use strategies to manage it.”
8. Focus on right now.
“When people are anxious, they are usually obsessing about something that might occur in the future,” Corboy said. Instead, pause, breathe and pay attention to what’s happening right now, he said. Even if something serious is happening, focusing on the present moment will improve your ability to manage the situation, he added.
9. Focus on meaningful activities.
When you’re feeling anxious, it’s also helpful to focus your attention on a “meaningful, goal-directed activity,” Corboy said. He suggested asking yourself what you’d be doing if you weren’t anxious.
If you were going to see a movie, still go. If you were going to do the laundry, still do it.
“The worst thing you can do when anxious is to passively sit around obsessing about how you feel.” Doing what needs to get done teaches you key lessons, he said: getting out of your head feels better; you’re able to live your life even though you’re anxious; and you’ll get things done.
“The bottom line is, get busy with the business of life. Don’t sit around focusing on being anxious – nothing good will come of that.”